Provider Demographics
NPI:1538650924
Name:NEWTON, NALANI M (PTA)
Entity type:Individual
Prefix:MS
First Name:NALANI
Middle Name:M
Last Name:NEWTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E SWISHER RD APT 3101
Mailing Address - Street 2:
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-2349
Mailing Address - Country:US
Mailing Address - Phone:940-600-2586
Mailing Address - Fax:
Practice Address - Street 1:300 E SWISHER RD APT 3101
Practice Address - Street 2:
Practice Address - City:LAKE DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75065
Practice Address - Country:US
Practice Address - Phone:940-600-2586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2099443225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant